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Balloon Sinuplasty In-Office

Partnering with the ENT specialty to deliver the future of sinus intervention

 

Clinical Benefits to an Expanded Patient Population1

  • Restore normal sinus drainage and function without bone or tissue removal, which preserves future treatment options
  • Offer a differentiated option for patients who decline or are ineligible for traditional surgery
  • Perform BSP In-Office Procedures within your comfortable office setting under local anesthetic
  • Consider the opportunity for earlier intervention when medical therapy has failed
  • Lower the financial burden for eligible patients (reduced copay and procedural costs)*

 

Practice Efficiency

  • Control all aspects of the procedure
  • Increase your productivity and reduce delays
  • Facilitate smooth procedures and positive patient experiences with a prepared office staff

 

Time-tested Technology

  • The only intranasal balloon dilation system tested in a 2-year, multicenter clinical trial (OR setting)2
  • Office-based clinical studies have demonstrated high safety, effectiveness, tolerability and patient satisfaction3
  • BSP In-Office differentiates you to current and future referring PCPs, building the critical foundation for success

 

Enduring Acclarent, Inc. Partnership

  • Acclarent programs ensure procedure and office transition success
  • Committed teams facilitate staff preparedness resulting in smooth procedures and positive patient experiences
  • Innovative technologies satisfy your patients’ demands for the latest advances in minimally-invasive care
  • Dedicated national programs accelerate awareness among patients and referring physicians

 

Reimbursement Highlights

 

Balloon-only FESS payment rates are appropriate and adequate to support BSP in your office.

 

In facility-based “hybrid” FESS procedures, balloon catheter instruments may continue to be used as adjuncts to traditional tools.

 

FESS Reimbursement Medicare National Average Rates 2014

All codes shown are unilateral (-50 modifier may be used for bilateral procedures, -51 modifier may be used for multiple procedures).

FESS Code Descriptions 2012

Additional Information

  • Balloon-only CPT codes may be used in conjunction with traditional FESS CPT codes for separate sinuses in a common procedure.
  • Balloon-only CPT codes may not be used in conjunction with traditional FESS CPT codes in a single sinus.
  • Per AAO-HNSF coding guidelines, the use of balloon catheter tools may be coded with traditional FESS CPT codes when 1) balloon catheter instruments are used in conjunction with other tools and 2) tissue is removed as part of intervention on that sinus.

 

BSP In-office PDF [PDF]

 

1Karanfilov B, et al. "Office-Based balloon sinus dilation: a prospective, multicenter study of 203 patients." Int Forum Allergy Rhinol; Nov 2012 Epub

 

 

2Weiss, et al, “Long-term outcome analysis of balloon catheter sinusotomy: Two-year follow-up.” Otolaryngology-Head and Neck Surgery; 2008, (139)3S3: S38-S46.

 

 

3Albritton, F et al. "Feasibility of in-office endoscopic sinus surgery with balloon sinus dilation." Am J Rhinol Allergy; 2012, 26: 1-6.

 

 

ORIOS 2 Study. Data on File.

 

*Some eligible patients may have lower out-of-pocket costs if the procedure is performed in a lower cost of care setting, such as a physician's office.

 

Please contact the ACCLARENT Reimbursement Hotline (Acclarent.reimbursement@its.jnj.com) with your specific reimbursement questions.

 

 

Not all codes provided are applicable for the recommended uses of Acclarent products. The most appropriate code for the patient’s clinical presentation must be selected.

 

CPT Copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS restrictions apply to government use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Sources: Calendar Year 2013 Medicare Physician Fee Schedule, Final Rule. Federal Register, November 16, 2012. Updated with changes from the American Taxpayer Relief Act of 2012, January 2, 2013. No geographic adjustments have been made to the reported payment rates. Multiple surgery payment amounts based on guidance provided in the Medicare Claims Processing Manual, Chapter 12, 40.6. The information contained in this guide is provided to assist you in understanding the reimbursement process.

It is intended to assist providers in accurately obtaining reimbursement for healthcare services. It is not intended to increase or maximize reimbursement by any payer. We strongly suggest that you consult your payer organization with regard to local reimbursement policies. The information contained in this document is provided for information purposes only and represents no statement, promise or guarantee by Acclarent concerning levels of reimbursement, payment or charge. Similarly, all CPT & HCPCS codes are supplied for information purposes only and represent no statement, promise or guarantee by Acclarent that these codes will be appropriate or that reimbursement will be made.